Eun Sub Jang, D. D. S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

48468 Issued in CA

Practice address

7138 Willow St
Sebastopol, CA 95472-4306

Phone

(707) 823-5308

Fax

(707) 823-5256

NPI assigned

Jan 31, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• E. Jang Dental Corporation

  • Dentist
  • Sebastopol, CA
  • NPI 1255474946
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415577600000",
    "number": "1467599274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7138 WILLOW ST",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954724306",
            "telephone_number": "707-823-5308",
            "fax_number": "707-823-5256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7138 WILLOW ST",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954724306",
            "telephone_number": "707-823-5308",
            "fax_number": "707-823-5256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANG",
        "first_name": "EUN SUB",
        "name_prefix": "Dr.",
        "credential": "D. D. S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-31",
        "last_updated": "2014-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "48468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Paul Jacobs, LCSW
• Marsha Wolfe Jacobs, MFT
• Samantha Marie Jacobs, M.S.P.T.
• Jaiyen Spa
• James F Yusuf Q Erskine DO Inc
• Barbara Anne Jason, PHARMACY TECHNICIAN
• Elizabeth Marie Jimenez, LCSW
• Angelica Roseria Jochim, MFT
• Jill Johnson, RD
• Judith Blackbird Joinville, LMFT

• General Practice Dentistry in Sebastopol, CA
• Providers in Sebastopol, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.